The researchers set out to study "the real life challenges and HIV-risk behaviors of male-to-female (MTF) transgender youth from communities of color." Working with a convenience sample of 51 ethnic-minority MTF transgender youth ages 16-25, they administered a questionnaire to assess demographics, psychosocial measures, and substance use and sexual risk behaviors. The researchers used descriptive analyses and analyses of association to interpret the data gathered.

Fifty-seven percent of participants were African-American; the study population's median age was 22; and 22 percent reported being HIV-positive.

In the previous year, 98 percent reported sex with men; 49 percent reported unprotected receptive anal intercourse; and 53 percent reported sex under the influence of alcohol or drugs. Substance use was common in the previous year: 71 percent reported using marijuana, and 65 percent used alcohol.

Injection of liquid silicone (ever in lifetime) was reported by 29 percent. However, other injection drug use or needle-sharing was rarely reported. In comparison to other racial/ethnic groups, HIV was found at higher rates among the African-American youth (p<.05). The researchers found that HIV status was not associated with any other demographic characteristic, psychosocial measure, or sexual or substance use behavior.

Life stressors reported by participants included a history of incarceration (37 percent), homelessness (18 percent), sex in exchange for resources (59 percent), forced sex (52 percent), difficulty securing employment (63 percent), and difficulty accessing health care (41 percent).

The researchers concluded that their findings suggest future research is needed to understand MTF transgender youth of color, who "have many unmet needs and are at extreme risk of acquiring HIV", in order to develop "broad-based interventions that reduce risky behavior."

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